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Yoga & Breast Cancer

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Phoebe Doherty

on 14 April 2014

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Transcript of Yoga & Breast Cancer

Yoga & Breast Cancer
Yoga- A Philosophy
Derived from the Sanskrit root of yoke/union, the practice of Yoga seeks integrate all aspects of the individual (Levine et al. 2012).

This balance is often described as an equilibrium between the inner active and passive energies, a union of yin and yang, effort and surrender (Rankin-Box, 2009).

Yoga seeks a union of the physical, mental, emotional, and
spiritual- ultimately resulting in a purposeful and
balanced life (Stevinson et al. 2010).
Numerous factors should be considered prior to commencing a yoga practice; stage of cancer, type or treatment, levels of fatigue, cardio function, chronic conditions such as elevated blood pressure (Loudon et al. 2012).
There is no 'one size fits all' yoga practice, and each scenario will have unique contraindications.

Radio therapy involves deep internal burning, therefor excessive tissue movement and stretching in those areas should be avoided (Ojha, 2012). Also, women on aromatase inhibitors may get hot flushes and hence heavy physical exertion may increase discomfort.
Benefits of Yoga
Improves psychological health
Stress reduction
Reduces Lymph edema symptoms
Improves sleeping patterns
Improves physical/ emotional/ social function
Psycho-spiritual support
Increased limb mobility
Current Constraints to Implementing Yoga Interventions
Lack of support from medical model
Complementary therapy prejudice
The need for adequate patient education
Patient access to appropriate resources i.e classes
Maintaining participation
Not supported by general health funds
Need for further randomized trials
Breast Cancer & Yoga
National Implications
World wide, breast cancer is the most frequently diagnosed form of cancer in women. In 2008 alone, there were more than 1.5 million new cases. Due to improved early diagnosis and treatments, survival rates continue to improve. However, patients experience many serious side effects during treatment that can lead to reduced quality of life and decreased psychological health may persist even after remission.

Cancer-related fatigue afflicts up to 33% of breast cancer survivors, yet there are no 'traditional' empirically validated treatments for this symptom (Balk, 2012). Studies show that Yoga, as a form of complementary therapy, can drastically improve patients quality of life and minimize the presentation of side effects and treatment related symptoms- such as fatigue. As an alternative to a purely medical model of treatment (Garet et al. 2012), Yoga could provide a genuinely valid supplementary tool for Australian women faced with this fight, and road to recovery.
Yoga and the Nurse
Complementary and alternative therapies (CAT) are an adjunct to conventional medical regimes, and the RN has an integral role in the coordination and facilitation of such therapies. RN's can, and often use, holistic nursing therapies that can be described as complementary or alternative in nature (Stevinson et al. 2009).

RN's should obtain and maintain appropriate education and clinical experience in order to maintain competency in CAT (Burk et al. 2013). RN's should be familiar with nursing practice guidelines and perform only those therapies inherent in the RN’s scope of practice.

RNs have an ethical and professional responsibility to support an individual’s choice regarding health care and educate the patient about various therapeutic options and
the risk and benefits associated with each.

Music 'Breathe Me' - Sia
A Brief History
Thought to originate over 3000 years BC in ancient India, Yoga predates written history (Wiley, 2010). The discipline was originally passed down orally from YOGACHARYA (teacher) to YOGI (disciple).

Approximately 2000 years ago, the Indian scholar Patanjali compiled what is now known as the Yoga Sutras (196 precepts in total) which described poses, postures and transitions as were orally taught (Wiley, 2010).

Patanjali's work now forms the foundation for the most common and famous forms of Yoga practiced throughout the globe today (Wiley, 2010).

Brought to the West in the late 19th and early 20th centuries, Yoga gained a foothold as a popular form of exercise and stress relief in the 1970's Ohja, 2012). Today, it is gaining recognition as a valuable complementary therapy and is used to treat many conditions- including
breast cancer (Ohja, 2012).
"Yoga teaches us to cure what need not be endured and endure what cannot be cured.” ~ B.K.S. Iyengar

What is Yoga?
sanskrit- 'yoke, union'
Yoga is an ancient discipline thought to originate 3000 years ago in India (Carlson et al. 2006). This spiritual and ascetic practice encompasses breath control, meditation, body poses and postures. In modern Western culture Yoga is commonly practiced for health benefits and relaxation (Danhauer et al. 2009).

Increasingly, studies are examining the effectiveness of Yoga as a complimentary and integrated intervention for serious and debilitating conditions such as cancer, respiratory conditions, cardiac illness and mental health conditions (Carlson et al. 2006). And the results are promising. In 2013, one in four Australian women diagnosed with breast cancer used some form of complementary alternative medicine (CAM) as an adjunct to medical model treatment (Burk et al. 2013).
"The stilling of the changing states of the mind"
Yoga Sutras of Patanjali
'Yoga teaches us to cure what need not be endured and to endure what cannot be cured.' B.K.S. Iyengar
Body with mind, mind with soul.
Yoga is among the most commonly used complementary treatment among breast cancer sufferers and survivors (Archer, 2011). Systematic reviews and randomized control studies show that in particular, Yoga improves psychological health and lymphatic system function (Garet et al. 2012). Improved quality of life and state of mind leads to decreased cortisol levels, increased immune functioning, and increased sleep- all of which have reported significant impacts on general well-being and outlook (Mihalko et al. 2009). Some studies
show that improvements
in these areas can be seen in as little
as 8 weeks during the course of a yoga
intervention program (Lange et al. 2012).
'Let your practice be a celebration of life.'

Seido lee deBarros
Yoga as Cancer Treatment Now
Yoga and exercise classes, retreats and events are often offered at discounted or no cost to breast cancer patients.
National Programs are:
Anahata Healing offers free yoga classes around Australia for those affected by cancer; anahatahealing.com.au
Breast Cancer Network Australia and National Breast Cancer Foundation host events to inform, support and fundraise for women affected by breast cancer; bcna.org.au, nbcf.org.au
The Otis Foundation provides retreats for women and men living with breast cancer at no accommodation charge; otisfoundation.org.au
YWCA Encore offers post-surgery exercise programs including a floor-based regimen and hydrotherapy pool access; ywcaencore.org.au

“When I first attended a yoga class with Annette, I was feeling sick, isolated, weak and depressed. I was full of fear and doubt as to whether my life and body would ever be normal again, but even after the first session I started to feel that cloud lift,”

Dianne Mann, breast cancer survivor, diagnosed 2010
Wrapping up
Numerous studies have mirrored Mann’s testimony, confirming yoga complements modern mainstream medicine by addressing the physical, psychological and emotional responses to breast cancer diagnosis and treatment. Reported benefits include stimulation of lymph flow, reduced fatigue and nausea, and enhanced sense of well-being through application of restorative practices such as movement (asana), meditation, chanting, visualisation and breathing techniques (Parlour et
al. 2012).
“The therapeutic application of yoga is predicated on the philosophy that the body has a natural tendency towards health and gently works to facilitate the removal of obstacles—one of those being sickness—by treating the whole person rather than just the symptoms of disease,” -
Susan Cosgrave, 2010

Cosgrave herself has endured two mastectomies, eleven years apart.

“Because of my yoga practice, I’d go into my appointments without so much fear and despair, knowing it was a journey and I would come out the other end.

Looking back on it, I think ‘how did I survive that journey?’, and I wouldn’t have without yoga. It made me come alive again,”

Dianne Mann, 2010
In closing...
Yoga benefits cancer patients on many levels, including stress and pain management. Although more studies are required, yoga as a way of treating cancer is moving from 'alternative' to accepted. There are some situations in which yoga is contraindicated for breast cancer patients so it is important to consult your treatment team and yoga practitioner.

Seek support, yoga might just be the thing to bring you through the darkness.

Wholeistic Approach
Yoga is unlike other forms of gentle exercise such as pilates, or relaxation activities such as mindfulness, as it seeks to link the mind with the body (Parlour et al. 2012). Yoga is a discipline where both mind and body are equally important and connected (Barnett et al. 2012).

The breath focuses the mind.
The postures focus the body.
One cannot be balanced without the other.
Archer, S. (2011). "Yoga and breast cancer survivors." IDEA Fitness Journal 8(6): 86-89.
Bower, J., et al. (2012). "Yoga for persistant fatigue in breast cancer survivors." Cancer 118(15): 3766-3775.
Culos-Reed, N., et al. (2006). "A pilot study of yoga for breat cancer survivors: physical and psychological benefits." Psycho-Oncology 15(10): 891-897.
Danhauer, S., et al. (2009). "Restorative yoga for women with breast cancer: findings from a randomized pilot study." Psycho-Oncology 18(4): 360-368.
Harder, H., et al. (2012). "Randomised controlled trials of yoga interventions for women with breast cancer: a systematic literature review." Supportive Care in Cancer 20(12): 3055-3064.
Holger, C., et al. (2012). "Yoga for breast cancer patients and survivors: a systematic review and meta-analysis." BMC Cancer 12(1): 412-415.
Holger, C., et al. (2012). "Can yoga improve fatigue in breast cancer patients? A systematic review." Acta Oncologica 51(4): 559-560.
Levine, A. and J. Balk (2012). "Pilot study of yoga for breast cancer survivors with poor quality of life." Complementary Therapies in Clinical Practice 18(4): 241-245.
Loudon, A., et al. (2012). "The effect of yoga on woemn with secondary arm lymphoedema from breast cancer treatment." BMC Complementary and Alternative Medicine 12(6): 66-72.
Ojha, K. (2012). "A Case Study: Investigation of Yoga's Potential to Treat Breast Cancer Survivors Facing Cancer Related Fatigue." Journal of Yoga & Physical Therapy 2(5).
Puymbroeck, M. V., et al. (2013). "Percieved Health Benefits from Yoga among Breast Cancer Survivors." American Journal of Health Promotion 27(5).
Rankin-Box, D. (2009). "Emotional benefits of yoga for women with breast cancer." Complementary Therapies in Clinical Practice 15(3): 182-184.
Speed-Andrews, A., et al. (2010). "Pilot Evaluation of an Lyengar Yoga Program for Breast Cancer Survivors." Cancer Nursing 33(5): 369-381.
Wiley, J. (2010). "Yoga leads to improved Quality of Life in breast cancer patients recieving radiotherapy." Focus on Alternative and Complementary Therapies 15(2): 149-151.

Reference List
Yoga & Sociology
Sociology is the critical study of human society; the way we organize ourselves & each other. Examples include schooling institutions, systems of government, local sporting clubs- even medical models and yoga groups. Why do we do the things we do?

Sociologically speaking in Australia, the biomedical model is what pervades our perception of health and wellness. Complementary and alternative medicines and practices such as yoga do not traditionally fit into this socially accepted construct.

However, with growing awareness of the benefits of CAMs, increasing research into this field is making these types of adjunct treatments more of a social
norm, and less of a societal annomaly.
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